HIV/AIDS: the “Geneva patient”, 6th patient in remission, recounts his journey

This is the “Geneva patient”, in reference to the five patients declared to be cured of HIV throughout the world (in Berlin, London, Düsseldorf, New York and City of Hope). However, Romuald, who today emerged from anonymity, represents a special case, here is why.

The “patient from Geneva”, Romuald, emerges from anonymity

In The Parisian, Romuald, 51-year-old Franco-Swiss, emerges from anonymity and is proud to embody hope on the occasion of World AIDS Day. He admits that he was not ready before, afraid of being judged, proof that the disease retains its bad reputation.

He tells how his HIV status was revealed to him when he was a young 18-year-old model. Over the years and with therapeutic progress, Romuald managed his illness until 2018. He was diagnosed with leukemia with a grim prognosis: “At the hospital, in a dark 6 m2 office, I was told that, without treatment, I had 6 months to live.“.

The treatment is a bone marrow transplant: heavy chemotherapy and radiotherapy to destroy the cancer cells – those of the immune system -, 3 months in a sterile room, a compatible transplant is scheduled.

A bone marrow transplant, not carrying the protective mutation

These new cells were replaced by those of the patient after a month, having the effect of reducing the quantity of virus in his body. The doctors then decided to gradually reduce his antiretroviral treatment until removing it in November 2021. Since then, the analyzes carried out have detected neither viral particles, nor an activatable viral reservoir, nor an increase in immune responses against the virus in the patient’s body. patient.

The five patients declared as probably cured of HIV were transplanted with bone marrow from a donor carrying a rare genetic mutation called CCR5 delta 32, known to make cells naturally resistant to the virus.

The particularity for this patient from Geneva, the graft did not carry this rare mutation. After stopping his treatment, HIV remained undetectable in his body.

A remission that remains to be understood

“This result is surprising” Professor Jean-Paul Viard, head of the immuno-infectiology department at Hôtel-Dieu, told us in July 2023. “However, we must remain cautious, because many cases have been published and for which it was ultimately a failure. For this patient, it is not yet clear why this seems to work, at this time. Is it due to genetic particularities? Is it related to the fact that the patient was treated quickly after his primary infection, which did not allow the quantity of virus to grow in his body and create a viral reservoir? These are just hypotheses” adds the specialist.

Now that we know more about Romuald’s journey, it is perhaps because of the initial rejection of the transplant according to the researcher interviewed in Le Parisien, Dr. Asier Saez-Cirion, research director at the Pasteur Institute “The new immune system then becomes aggressive and fights the cells of the patient carrying HIV. it is undoubtedly one of the factors which contributed to eliminating the viral reservoir“. New chemo will cure cancer.

“Bone marrow transplantation cannot constitute the treatment of HIV”

If the reasons for this remission are not yet entirely clear, one thing is certain: bone marrow transplantation cannot be considered as a potential treatment for HIV. “These patients benefit from a bone marrow transplant due to the serious pathologies that affect them. But it is certain that for the millions of people affected by HIV, it is better to live with a pill to take every day than to suffer the consequences of a therapy as heavy as bone marrow transplantation.” concludes Professor Viard.